Provider Demographics
NPI:1356440218
Name:NEW MARKET PHARMACY INC
Entity Type:Organization
Organization Name:NEW MARKET PHARMACY INC
Other - Org Name:NEW MARKET PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:FANSLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-740-9393
Mailing Address - Street 1:PO BOX 1288
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:VA
Mailing Address - Zip Code:22844-1288
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9438 CONGRESS STREET
Practice Address - Street 2:
Practice Address - City:NEW MARKET
Practice Address - State:VA
Practice Address - Zip Code:22844
Practice Address - Country:US
Practice Address - Phone:540-740-9393
Practice Address - Fax:540-740-9330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
VA02010033933336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA8508941Medicaid
4830320OtherNCPDP PROVIDER IDENTIFICATION NUMBER
1164730001Medicare NSC